INTESTINES 121 



On the inner surface of the duodenum just behind the pylorus 

 is seen a small prominence the bile papilla on which is the 

 common opening of the bile and pancreatic ducts. 



The Jejunum is the second part of the small intestine, and the 

 Ileum is the third part. They measure about 20 feet together, 

 and start at the duodeno-jejunal flexure, ending by the junc- 

 tion of the ileum with the large intestine at the colic valve. 



The coils of the small intestine lie in the abdominal cavity, 

 varying considerably in their disposition, as they are in continual 

 movement. 



There is very little difference between the jejunum and ileum, 

 and the transition of one to the other is gradual. The ileum is 

 smaller in diameter, has fewer valvulae conniventes and a larger 

 number of Peyer's patches than the jejunum. 



The Large Intestine consists of several parts the csecurn, 

 ascending, transverse, and descending colons, sigmoid flexure of 

 colon, and rectum. 



The structure is similar to that of the small intestine except 

 that it has no villi and the longitudinal coat of muscle consists 

 of three longitudinal bands, so that the organ has a sacculated 

 appearance. 



Small processes of peritoneum distended with fat called 

 appendices epiploictf hang from the outer wall of the large 

 intestine. 



The Caecum is a small sac about 2-J inches long and 3 inches 

 wide which forms the blind end of the large intestine and lies- 

 below the colic valve, or entrance of the ileum into the large 

 intestine ; it lies in the right iliac fossa in front of the psoas 

 muscle. Just below the colic valve, the appendix opens out 

 from the caecum. It is a small blind process, very often with no 

 lumen at all, about 3J inches long; it lies behind the caecum,, 

 generally pointing upwards and to the left, but the position is 

 very variable. 



The Ascending* Colon (length about 8 inches) is the continua- 

 tion upwards of the caecum. It lies in the groove between the 

 right psoas and quadratus lumboruni, and the front of the right 

 kidney. When it reaches the liver it forms the hepatic flexure 

 by bending at an angle to the left and is continued as 



